by on June 20, 2024

What is Complex Regional Pain Syndrome?

Complex Regional Pain Syndrome (CRPS) is a chronic pain condition that usually affects an arm or leg. It causes ongoing and severe pain out of proportion to any injury. The pain is intense and debilitating.

Causes and Risk Factors

The exact cause of Complex Regional Pain Syndrome is unknown, but it often develops after an injury, surgery, stroke or heart attack. Nerves mistakenly send pain signals to the brain in a chronic and often uncontrolled way. This can happen after an injury because of increased sensitivity to pain (hyperalgesia). Other risk factors include:

- Highly sensitive nervous system.

- Genetics.

- Psychological factors like depression, stress, and post-traumatic stress disorder.

Symptoms and Diagnosis

Symptoms of CRPS include:

- Persistent severe burning pain, often described as being worse than childbirth.

- Pain that is out of proportion to the severity of the initial injury.

- Changes in skin color, temperature and/or texture over the affected area (swelling, sweating or thinning skin).

- Stiffness and limited joint mobility in the affected arm or leg.

- Changes in nails and hair growth.

- Tremors or inability to use the arm or leg.

To diagnose CRPS, a doctor will conduct a physical exam and review the patient's medical history. Additional tests like a bone scan or thermography may be used to detect temperature changes in the skin. Skin biopsies can also help identify signs in nerve fiber growth.

Treatment Options

The main goals of treatment are to manage pain and improve function. Early intervention offers the best results. Treatment can include:

- Medications: Prescription analgesics, nerve blocking medications, topical creams.

- Therapies: Physical therapy, occupational therapy, aqua therapy or psychotherapy.

- Nerve blocks: Injecting local anesthetics around nerve pathways.

- Surgery: Sympathetic nerve blocks or revision surgery in rare cases.

Most patients feel better when using a multidisciplinary treatment plan involving medications, physical rehabilitation, education, and psychological support. Lifestyle changes like doing gentle range-of-motion exercises as able also helps recovery. For some patients, a spinal cord stimulator implanted near the spinal cord may help control pain.

Impact on Daily Life and Work

CRPS can be severely disabling if not managed properly. The ongoing severe pain often restricts movement, mobility, strength and functioning. This takes a toll on many aspects of daily living and impacts professional and personal responsibilities. Many CRPS patients are unable to return to the same work duties and must seek alternate job roles or take extended medical leave. Managing CRPS effectively returns patients closer to normal life activities and prevents long term disability.

The Economic Burden of CRPS

CRPS leads to direct healthcare costs as well as indirect costs from lost wages and reduced productivity. Some estimates include:

- Average healthcare cost up to $30,000 in the first year after diagnosis

- Indirect costs from lost income, changing jobs and home health aides average over $50,000.
- Over 40% of patients are permanently work-disabled within 5 years without effective treatment.

- Work productivity losses top $130,000 per CRPS patient after 7 years.

Employers end up bearing significant expenses from employee disabilities, replacements costs and workplace accommodations. Early recognition, medical care and physical rehabilitation can reduce costs by preventing chronic pain disability. Failing costs rise exponentially as CRPS worsens over time. Proactive treatment strategies are critical for reducing the economic burden of CRPS.

CRPS can severely impact quality of life if not properly addressed. Early and ongoing management with a multidisciplinary team offers the best chance for recovery. Employers must adopt policies providing CRPS support while minimizing costs of long term disability. Further research helps advance treatment protocols for this painful condition. Overall, raising CRPS awareness benefits patients and the economy.

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